A urinary tract infection or UTI is an infection in a person’s kidney, ureters, bladder, or urethra. If left untreated, UTIs may result in significant complications (R). For some people, UTIs are recurrent, meaning that they can recur or happen repeatedly. Therefore, whether you have recurrent UTIs or whether it is your first time, UTI tracking is very important.
The urinary tract consists of the kidneys, ureters, bladder, and urethra (R). Urine forms in the kidneys. Then, urine is sent to the bladder through the ureters, where it is collected. Once enough urine is collected in the bladder, it is removed from the body or urinated through the urethra. The major difference between men and women is that the opening of the urethra is closer to the bladder in women than it is to men.
While both men and women are susceptible to UTIs, UTIs are more common in women because of their shorter urethras (R). Approximately 50% of women will have at least one UTI in their lifetime. Between 20%-30% of women who present with a UTI will have a recurrent UTI within the next 6 months, and on average will have 2-3 recurrent UTIs within the following year. Elderly individuals are at greater risk of acquiring a urinary tract infection, particularly if they are hospitalized or if they reside within a long-term care home. People who have diabetes, particularly if it is uncontrolled or if they are taking certain treatments for diabetes are at greater risk of UTIs because of sugar that is found within their urine. Also, people who are sexually active are at greater risk for a urinary tract infection.
Signs and Symptoms
General Symptoms
- Dysuria – pain or difficulty urinating, people often feel a burning sensation while urinating
- Greater frequency – passing small amounts of urine frequently
- Greater urgency – a more intense and persistent urge to urinate
- Foul smelling or pungent urine
- Hematuria – blood within urine, often seen as a red or bright pink color in the urine
- Urine that is cloudy or has pus
- In women, pelvic pain near the pubic bone
Symptoms Indicating a Kidney Infection
- Upper back pain
- Flank or side pain
- Fever
- Chills
- Nausea and/or vomiting
Symptoms Indicating a Bladder Infection
- Dysuria
- Hematuria
- Greater urinary urgency and frequency
- Pelvic pain or pressure
- Discomfort in the lower abdomen
Symptoms Indicating an Infection of the Urethra
- Dysuria, particularly the burning sensation while urinating
- Discharge, such as pus
What are potential complications associated with UTIs?
It is important to treat urinary tract infections to avoid potential complications associated with them. One of the complications of UTIs is recurrent UTIs. About 25% of women are likely to have another UTI within 6 months of the first UTI and another 2-3 additional UTIs within a year of the first UTI. Pregnant women who experience urinary tract infections have an increased risk of delivering babies with lower birth weights or delivering premature babies. Men who have UTIs are at risk of urethral narrowing or stricture. Urinary tract infections that are not treated can also result in permanent kidney damage. In the worst cases of infection, sepsis, which is a potentially life-threatening complication of an infection, can occur, especially if the infection travels to the kidneys.
What causes UTIs?
Most urinary tract infections are caused by bacteria that enter and then multiply within the kidneys, ureters, bladder, and/or urethra (R). E. coli is the bacteria most often associated with urinary tract infections of the bladder and accounts for approximately 70% of all urinary tract infections (R). E. coli is a type of bacteria that is commonly found in the gastrointestinal or digestive tract, such as your colon, rectum, or small intestines. Other types of bacteria from the gastrointestinal tract may cause UTIs. Sexually transmitted infections (STIs), such as chlamydia and gonorrhea can cause urinary tract infections. STIs typically cause UTIs within the urethra and enter the urethra because of sexual intercourse. Fungal infections are a much less common cause of UTIs.
What are the types of UTIs?
There are two types of urinary tract infections: complicated and uncomplicated. Uncomplicated UTIs involve people with normal, healthy urinary tracts that are not blocked or obstructed. These typically occur in younger, sexually active women.
Complicated UTIs are infections that are associated with anatomical or structural blockage of the urinary tract. They may also be associated with physiological or functional abnormalities in the urinary tract, or when a person has an underlying disease or condition, which makes it easier to get urinary tract infections. Anyone who has had surgery in their urinary tract, a kidney transplant, or a catheter inserted in their urethra is at risk of a complicated UTI. Anyone who has received chemotherapy or radiation therapy for the treatment of their cancer is at risk of a complicated UTI. Also, people who have diabetes, chronic kidney disease or a compromised immune system are at risk of acquiring a complicated UTI.
What is the impact of UTIs?
Urinary tract infections have a significant impact on the health of a population. In the United States, UTIs account for 7 million healthcare provider visits, 1 million emergency department visits and 100,000 hospitalizations each year. UTIs are also responsible for 25% of the infections within older adults, aged 65 or older, within the United States. Over $3.5 billion in the United States is spent each year to manage and treat UTIs.
When should I go see my doctor about a UTI?
If you think you have signs and symptoms of a urinary tract infection, you should contact your primary care provider, such as a family physician or nurse practitioner to discuss your signs and symptoms with them. Depending on your situation, your primary care provider can manage your care directly, or they may refer you to a urologist for specialist care. A urologist is a specialist physician that treats conditions in the male reproductive system and in the urinary tracts of both men and women.
How is a UTI diagnosed and evaluated?
Your healthcare provider will obtain a focused history and will ask you detailed questions about your signs and symptoms. This is part of the reason why urinary tract infection monitoring is important. You want to give your healthcare providers the best information about your signs, symptoms, and medical history, so they can properly diagnose and evaluate your condition.
They will most likely order urine tests so that a clinical laboratory can perform tests on your urine to determine if you have a urinary tract infection. These tests are typically called culture and sensitivity tests. From your urine sample, the laboratory will place a swab on a petri dish to see what bacteria or fungi will grow on the dish, to determine what you are likely infected with. Afterwards, the laboratory will perform a sensitivity test to determine which medications, such as antibiotics, would be effective in treating or curing the infection.
If your healthcare provider suspects that you might have a complicated UTI or infections that are due to structural or functional abnormalities in your urinary tract, they may order imaging tests to determine or rule that out. Imaging tests include computed tomography (CT) scans, magnetic resonance imaging (MRI) scans. If your healthcare provider suspects recurrent UTIs, they may order a cystoscopy to see inside your bladder. A cystoscopy is the insertion of a camera in your urethra, through a long thin tube, and passed through to your bladder.
What are the treatments for UTIs?
Antibiotics
Given that the primary causes of urinary tract infections are bacterial infections, the main treatments for UTIs are antibiotics (R).
Commonly prescribed antibiotics for uncomplicated UTIs:
- Amoxicillin/clavulanate (Augmentin)
- Cefaclor
- Cefdinir
- Cefpodoxime
- Cephalexin (Keflex)
- Ciprofloxacin (Cipro)
- Extended-release ciprofloxacin (Cipro XR)
- Gatifloxacin (Tequin)
- Fosfomycin (Monurol)
- Levofloxacin (Levaquin)
- Nitrofurantoin (Macrodantin, Macrobid)
- Trimethoprim-sulfamethoxazole (Bactrim, Septra, others)
If you undergo a sensitivity test, your prescribing healthcare provider will know what medications your infection is sensitive to and will prescribe medications according to those sensitivity tests. Otherwise, your prescribing healthcare provider may prescribe antibiotics in a tiered fashion. This means that they will prescribe you certain antibiotics and follow up with you within four to six weeks to see how well you respond to the medication. Your prescribing healthcare provider will order additional urine tests to determine the effectiveness of your treatments. Urinary tract infection monitoring is an important part of the follow-up process and determining whether treatment is effective.
Monitoring Antibiotics
If the antibiotics they first prescribed to you were not effective in treating or curing your infection, they will likely decide to prescribe you with another antibiotic and then monitor your response to the new treatment. Your prescribing healthcare provider will repeat this process until the medications are effective in treating your infection. They will also use that process if you have recurrent UTIs.
Prescribers will first use fosfomycin (Monurol), nitrofurantoin (Macrodantin, Macrobid), or Trimethoprim-sulfamethoxazole (Bactrim, Septra, others) as first-line antibiotics. If those first-line antibiotics are not effective, or if you have a recurrent UTI, they will move to second-line antibiotics. These second-line antibiotics include ciprofloxacin (Cipro) and levofloxacin (Levaquin). If first and second-line medications are not suitable, because of your allergies, potential drug interactions or your medical history, prescribers can use alternative antibiotics. Such antibiotics include Amoxicillin/clavulanate (Augmentin), cefaclor, cefdinir, cefpodoxime, and cephalexin (Keflex).
One of the considerations for prescribing healthcare providers is antibiotic resistance. Antibiotic resistance takes place when the bacteria that are causing your urinary tract infection are resistant or survive exposure to the antibiotics you are being treated with. This means that the antibiotics being used to treat your UTI become ineffective. Antibiotic resistance occurs naturally but is more likely to happen if people do not take their medications as prescribed. Therefore, it is important for patients to take their antibiotics as prescribed.
If you have a severe urinary tract infection, you will need to be hospitalized and treated with intravenous (IV) antibiotics that are injected into your bloodstream.
Other Therapies
Up to 30% of urinary tract infections clear up spontaneously within one week. Your healthcare provider may recommend that you treat your symptoms, such as pain during urination, by using nonsteroidal anti-inflammatory drugs (NSAIDs), such as acetaminophen or aspirin for one to two days. Your healthcare provider can take this approach if they follow up with you appropriately after your visit.
Cranberry products, such as cranberry juice or cranberry tablets, have been suggested to treat or prevent UTIs. However, the evidence for this is not conclusive. Some researchers argue that cranberry products may be more effective with women who have uncomplicated and recurrent UTIs, but not for other people who have UTIs. Cranberry products should not be taken by people who are taking warfarin or blood-thinning medications. Otherwise, taking cranberry products are low risk, and at most, may cause an upset stomach and diarrhea.
Healthcare providers recommend that people with UTIs drink plenty of water to help dilute your urine and flush out bacteria. They also recommend avoiding drinks that may irritate your bladder, such coffee or any caffeinated beverage, soft drinks, citrus juices, and alcohol. If you are experiencing abdominal discomfort because of your UTI, you may apply a warm heating pad to the affected area, to relieve bladder pressure and discomfort.
How do I prevent UTIs?
One way to prevent UTIs is to drink plenty of fluids, particularly water. This will help dilute your urine and flush out bacteria within your urinary tract, as you will be urinating more frequently. Both men and women should empty their bladders shortly after sexual activity to help flush bacteria from the urinary tract. Women are also recommended to wipe from front to back after urination and after every bowel movement to prevent bacteria from the anus from spreading to the vagina and urethra. Also, post-menopausal women who apply a vaginal estrogen cream daily, have been shown to reduce the risk of UTIs.
Cranberry juice is used to prevent urinary tract infections, but researchers are divided on whether it is effective in doing so. Probiotics may help women in preventing UTIs, but more researchers need to conduct more studies to determine whether probiotics are effective at preventing UTIs (R). Vitamin C and vitamin D may also prevent urinary tract infections, but as with probiotics, more research is needed before healthcare providers can recommend them as ways to prevent UTIs.
CareClinic’s for UTI Tracking
CareClinic is one of the best rated mobile health apps available. CareClinic is available for UTI tracking documenting. It allows you to track and monitor your symptoms, as well the steps you are taking to manage them. This app’s features will facilitate your urinary tract infection monitoring.
One of the features of the app allows you to schedule appointments in the app’s calendar. Whether you are seeing your primary care provider or urologist, or whether you have appointments for urine tests, these reminders can help you keep track of all your appointments. The app also has features to enter and track your nutrition. You can enter your fluid intake and the types of fluids you are drinking, whether it is water, cranberry juice, or something else.
Medication Reminder
One of the best and most well-known features of the app is it’s medication reminder feature. You can enter each medication you are taking and the time that you normally take your medication. Using this information, you can schedule medication reminders. Whether you are taking antibiotics or NSAIDs, these reminders can help you ensure you take your medications correctly and on time. Reports can also be generated, so you can track how well you are taking your medications.
Symptom Tracker
CareClinic can also track your pain and other symptoms. For each symptom, the app will ask you to rate the severity of each symptom from 0-10, with 0 being the least severe and 10 being the most severe. As with other metrics that the app can track, such as medication, you can generate a report to see how severe your pain and other symptoms are. Additionally, CareClinic has a diary feature that you can use to document your experience in managing your condition, whether you are experiencing more symptoms or more severe symptoms or whether your symptoms are improving. You can write diary entries as often as you would like. This information can help your healthcare providers know whether their prescribed treatments are working for you.
Care Plans
More importantly, the app allows your mobile device to sync directly with Apple Health or Google Health (depending on your device) and can be fully integrated to manage all your data input. CareClinic can also successfully integrate with other platforms, such as electronic medical records (EMRs) from physician’s offices or pharmacies, if permitted. This can allow you to seamlessly share your data with your care providers so that they can obtain better insights into your health and provide better care.
The premium upgrade for CareClinic, which allows you to gain access to communities of patients with similar conditions, custom care-plans, custom exercise plans, advanced reminders and more. One of the premium features includes the “Ask a Doctor Now” feature, which will allow you to ask a physician with over 26 years of experience in emergency and family medicine questions about your medical condition. There is also a specific care plan for UTIs. It is called the “Urinary Tract Infection Care Plan” and you can purchase this care plan separately. This custom care plan can help you better manage your UTI.
